Type 2 diabetes and metabolic syndrome in Filipina-American women - A high-risk nonobese population

OBJECTIVE- To compare the prevalence of type 2 diabetes and features of the metabolic syndrome among Filipina and Caucasian women in San Diego County, California. RESEARCH DESIGN AND METHOD- Data on several chronic diseases were collected between 1992 and 1999 from community-dwelling Filipina (n = 294) and Caucasian (n = 379) women aged 50-69 years. RESULTS- Filipina and Caucasian women did not differ in mean age (59.7 vs. 60 years, respectively), BMI (25.6 vs. 25.4 kg/m(2)), percentage of body fat (33.5 vs. 34.2%), or waist-to-hip ratio (0.84 vs. 0.83), although Filipinas had larger waist circumferences and high percentages of truncal fat. Compared with Caucasians, Filipinas were less likely to be obese (BMI greater than or equal to 30 kg/m(2), 8.8 vs. 14%, P = 0.04) and less likely to smoke, consume alcohol, or take postmenopausal estrogen: Filipinas also had lower levels of HDL cholesterol. Compared with Caucasians, Filipinas had higher prevalence of type 2 diabetes by oral glucose tolerance test criteria (36 vs. 9%) and the metabolic syndrome (34 vs. 13%). These differences persisted after adjusting for age, body size, fat distribution, percentage of body fat, smoking, alcohol consumption, exercise, and estrogen therapy. CONCLUSIONS- A total of 10% of Filipinas with diabetes were obese, compared with one third of Caucasians with diabetes. The finding of a high prevalence of diabetes in an unstudied nonobese ethnic group reinforces the importance of expanding the study of diabetes to diverse populations. The high prevalence of diabetes in populations who was not of Northern European ancestry may be missed when they are not obese by Western standards.